Comparative Analysis of Different Specific Indices of Hand Impairment in Systemic Sclerosis

Abstract

To the Editor: Hand involvement is often the first clinical manifestation of systemic sclerosis (SSc) during the disease course. Some indices such as finger-to-palm distance in flexion (FTP)1, the Hand Anatomic Index (HAI)2, and the Hand Mobility in Scleroderma test (HAMIS)3 have been developed to assess functional impairment by testing the reduction in range of motion or evaluating inability, but there is still no consensus whether they yield different information or are mutually interchangeable. We compared these 3 assessment tools used to quantify hand impairment in SSc, considering their associations with organ involvement. Our analyses were based on 80 consecutive patients with SSc (68 women, 12 men) referred to the Division of Rheumatology, Istituto Gaetano Pini, Milan; 60 were classified as having limited cutaneous disease (lcSSc; mean age 61.3 yrs) and 20 as having diffuse cutaneous disease (dcSSc; mean age 58.9 yrs). Judged from the first symptom attributable to SSc, 20 (33.3%) lcSSc and 6 (30%) dcSSc patients had disease of recent onset (< 5 and 3 years, respectively), whereas 40 (66.7%) lcSSc and 14 (70%) dcSSc patients had intermediate/late onset disease (≥ 5 and 3 years)4. To determine patients’ disease profiles on the basis of the pattern of … Address correspondence to Dr. Ingegnoli; E-mail: francesca.ingegnoli{at}unimi.it